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Retinoblastoma is leading cause of under-5 deaths

MUNIDE ZULU, Lusaka
MUMBA Sata is among many mothers that have lost their children to childhood cancers such as neuroblastoma and retinoblastoma, among others. The cancer afflicts children under the age of five and is the leading cause of deaths among children below the age of five.
Mrs Sata, who is executive director of Kayula Childhood Cancer Foundation, with other concerned citizens and stakeholders, champions raising awareness on childhood cancers like retinoblastoma, a cancer that starts in the retina.
During the early stages of development, the eyes have cells called retinoblasts that divide into new cells and fill the retina. At a certain point, these cells stop dividing and develop into mature retinal cells.
Rarely, something goes wrong with this process. Instead of maturing into special cells that detect light, some retinoblasts continue to divide and grow out of control, forming a cancer known as retinoblastoma.
It is the most common type of eye cancer in children, not only in Zambia but worldwide.
Mrs Sata, during a media breakfast meeting hosted by Kayula Childhood Cancer Foundation, implored the media, traditional leaders, politicians and the community to be aware of retinoblastoma as it is deadly if not diagnosed early.
She has also set up transit homes for parents of children with cancer and care-givers with shelter and other basic needs.
And during a visit at the centre, it was revealed that 21 children have been kept at the Kabulonga transit home since it was opened and 12 children have so far died from various childhood cancers.
Despite the disease being fatal, some medical personnel are not able to detect retinoblastoma, which has become a leading cause of mortality among children under the age of five, says University Teaching Hospital consultant Pediatrician Musukwa Sambo.
Dr Sambo says retinoblastoma is in one out of six children in Zambia unlike in Western countries, where the cure rate is high.
She said this type of cancer is in heritable form, which accounts for about two in every five cases and is caused by a genetic abnormality.
Dr Sambo said this means that an abnormal gene allows the tumour to develop. This abnormal gene may either be inherited from a parent or happen for the first time at an early stage of development in the womb.
She says children with retinoblastoma often experience symptoms or signs such as having a white pupillary reflex, which is the most common type.
In an eye with this cancer, the pupils often appear white or pink, which is known as a white pupillary reflex or orleukocoria.
This can only be noticed by a parent after a flash photograph is taken or during a well-baby examination by a doctor.
The other symptoms are if a child has lazy eyes that don’t appear to look in the same direction, vision problems, having painful eyes, a crossed eye, which is an eye looking either the ear or towards the nose and redness of the white part of the eye.
Others are bleeding in the front part of the eye, bulging of the eye, having a pupil that doesn’t get smaller when exposed to bright light and having a different colour in each iris, among others.
The country has continued to grapple with high cancer burden not only in children but elders as well. But retinoblastoma has been the biggest challenge because people are not aware of it, said UTH Cancer Disease Hospital consultant clinical oncologist Susan Msadabwe.
She also stressed the need for awareness programmes to be rolled out at community level, health posts and district hospitals in order for the disease to be detected early. This will help save lives of many children.
Dr Msadabwe said research and treatment are building on the progress made in treating retinoblastoma in Zambia.
She observed that countries in the Western world have managed to eradicate cancer in children such as retinoblastoma due to early detection.
“If the Western world can have a high cure rate for retinoblastoma, why should Zambia have a poor cure rate? We want to be like the Western world,” she said.
Dr Msadabwe said early detection of retinoblastoma will help Zambia achieve a high cure rate of the deadly disease in children.
She said this can be done by building capacity to confirm clinical diagnosis and treat retinoblastoma.
Several children are undergoing treatment at UTH such as radiation therapy and chemotherapy while others have died before and after treatment, though there are no statistics, Dr Msadabwe said.
Government is aware of the challenges in treating retinoblastoma and has rededicated its efforts in addressing the problem. This will give an opportunity to children to live a full and healthy life.
Minister of Community Development, Mother and Child Health Emerine Kabanshi said people with cancer deserve to have access to the full continuum of care that is necessary for the prevention, diagnosis and treatment of any form of cancer.
Ms Kabanshi said it is for this reason that Government has started a process of developing a cancer control strategy.
“This strategy will be a tool to allocate resources for long-term development of capacity both at the national and provincial levels to manage cancers,” she said.
Ms Kabanshi said prevention, screening and treatments will also be prioritised.

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